Applying a Nursing Theory a Nursing situation I experienced
In my nursing profession, I once encountered a compromising situation related to self-care deficit. A patient who had been previously discharged home from orthopedic care unit due to femur fracture presented in a medical-surgical ward with bed sores, malnutrition, and injuries on the same thigh. All these occurred within one month of receiving home-based care from his family. Upon investigation, the patient had developed poor self-care behaviors. He was not immobile but never used to get off the bed for some exercises and always resisted regular turning while in bed. He also soiled the beddings voluntarily, laid on wet linen for a long time without changing them. The outcome was the development of bed sores on the buttocks, elbows, and shoulders. He was selective on the types of food, refused to eat at times and often stayed hungry long than usual. In the long haul, malnutrition and slow recovery ensued. He used to be careless while handling the plastered thigh. He had a history of falls and reckless knocks to the affected limb. More injuries and damage to the femur. When bed sores developed, it took so long for him and family to detect them and seek health intervention in good time. During the management of the pressure ulcers, less attention was given to infection prevention. The patient practiced inadequate infection control measures, for instance, he maintained poor general body hygiene even on the sites of pressure ulcers. The ulcers had developed pus, smelling, and deepening to muscle tissues. The situation was devastating despite being preventable especially if the patient and family had sufficient knowledge on self-care practices in health promotion.
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Dorothea Orem’s Self-Care Theory
This theory defines nursing as the act of assisting others in delivery and management of self-care to improve health and body functioning at all levels of effectiveness. Self-care means the practice of activities which individuals initiate and perform on their behalf in promoting health, life, and well-being. Therefore, the theory focuses on the ability to perform self-care activities at a personal level.
Major concepts in the theory
Nursing
The theory portrays nursing as the art, assisting service, and technology through which health provider gives specific help to persons with deficits to meet self-care needs.
Health
Health refers to being structurally and functionally whole and sound.
Environment
Human being
Humans are capable of symbolizing, reflecting, and generating a meaning using the symbols.
Research support
Pressure ulcers are injuries to the skin and underlying tissue resulting from prolonged pressure on the skin. The majority at risk are people with conditions limiting their mobility and ability to change positions. Common symptoms include skin swelling, pus draining, abnormal skin color changes, and tenderness on palpation. They usually develop on the skin that covers bony areas of the body. The common sites of pressure sore involve buttocks, shoulder, ankles, hips, and back. The decubitus results from pressure exerted against the skin that limits blood flow to the skin.
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Maintaining proper infection is one of the golden objectives in severe conditions that involve exposure of tissues beyond the skin. Sustaining high levels of hygiene is one of the primary practices in infection prevention. Hygiene involves general body cleanness together with the affected body parts under management. Poor hygiene provides ground for infections manifestation and continuous development of adverse symptoms (Chhugani, Jacob, & James, 2017).
Personal philosophy
This theory paints a picture of my own belief and concept about nursing. All along my idea about nursing has been to provide holistic care to patients including home-based care. The theory portrays that this idea was ineffective in healthcare promotion.
Application of this theory
This theory will help me in various ways to be to be an advanced practicing nurse. It practically corresponds to the nursing process in the delivery of care. For instance, on the patient with bedsores, it is essential to determine the reason behind nursing care with consideration to assessment.
References
Chhugani, M., Jacob, S. M., & James, M. M. (2017). Nursing Care: Making a Big Difference in Stage 3 Bed Sore. Int. J. Nurs. Midwif. Res, 4(4), 4.
Hudgell, L., Dalphinis, J., Blunt, C., Zonouzi, M., & Procter, S. (2015). Engaging patients in pressure ulcer prevention. Nursing Standard (2014+), 29(36), 64.
Lannering, C., Ernsth Bravell, M., & Johansson, L. (2017). Prevention of falls, malnutrition and pressure ulcers among older persons–nursing staff’s experiences of a structured preventive care process. Health & social care in the community, 25(3), 1011-1020.
